Effectiveness of ureteroscope‐assisted renal puncture for endoscopic combined intrarenal surgery

Hamamoto, Shuzo; Hamamoto, Shuzo; Unno, Rei; Taguchi, Kazumi; Okada, Atsushi; Yasui, Takahiro

doi:10.1111/iju.13865

Cited by 6 publications

(4 citation statements)

References 6 publications

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“…Adding fURS to the PCNL procedure is both a diagnostic and therapeutic advantage [ 2 ]. From the diagnostic perspective, fURS allows evaluation of the anatomy of both the lower and upper urinary tract [ 2 ], endoscopic control of the renal access [ 7 , 9 , 17 ] and final endoscopic assessment for residual fragments [ 2 , 18 , 19 ]. From the therapeutic perspective, fURS allows the possibility of treating ureteral stones [ 20 ], treating contralateral kidney stones [ 21 , 22 ] and can be a valuable tool in synergistic cooperation during renal stone management [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Nonpapillary prone endoscopic combined intrarenal surgery: effectiveness, safety and tips, and tricks

et al. 2022

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Purpose To evaluate the effectiveness and safety of nonpapillary prone endoscopic combined intrarenal surgery (ECIRS) and provide practical tips and tricks for the successful accomplishment of the procedure respecting the anatomical particularities. Material and methods This study is an analysis of a prospectively collected database including all cases of ECIRS performed between January 2019 and December 2021 in a high-volume tertiary center. All patients underwent the procedure in prone-split leg position. A nonpapillary renal puncture was performed. The used access sheaths were 22Fr or 30Fr. Lithotripsy was performed anterogradely with a dual-energy lithotripter with incorporated suction and retrogradely with holmium Yttrium–Aluminum–Garnet laser. Results A total of 33 patients were included. The initial stone-free rate (SFR) was 84.8% and the final SFR was 90.9%. The median stone size was 35 mm and 60% of patients had staghorn calculi. The prevalence of renal abnormalities was 21.3%, including 3 cases of horseshoe kidney, 2 cases of malrotation and 2 cases with complete duplicated systems. The median operative time was 47 min. The median hospital stay was 3 days and median hemoglobin loss was 1.2 gr/dL. Overall, the complication rate was 9.1%, all being Grade II complications (n = 2 fever and n = 1 transient bleeding). Conclusions Nonpapillary prone ECIRS is an effective and safe procedure. Standardization of the procedure is critical to achieve good outcomes. Patients who benefit the most are probably the ones where additional punctures can be avoided using this technique, namely patients with renal abnormalities, incrusted ureteral stents and staghorn stones.

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Section: Discussionmentioning

confidence: 99%

Nonpapillary prone endoscopic combined intrarenal surgery: effectiveness, safety and tips, and tricks

et al. 2022

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“…Then the controlled pressure system was used to suction residual lithotripsy to ensure the normal function of the kidney and ureter system, and the residual stone rate was low (7,8). There are limited samples of ultra-mini percutaneous nephrolithotripsy and macroscopical treatment in foreign countries, and there are few studies on polycystic kidney combined with renal stones (9). In this study, ultra-mini percutaneous nephrolithotripsy combined with ShuoTong ureteroscopy was used to treat 42 patients with polycystic kidney disease combined with renal stones admitted to our hospital, and the effects on the stress response, inflammatory indexes and urokinase levels were observed and analyzed.…”

Section: Introductionmentioning

confidence: 99%

Effect of ultra-mini percutaneous nephrolithotomy and ShuoTong ureteroscopy on the stress response, inflammatory indices, and urokinase level in patients with polycystic kidney disease complicated with renal calculus

Cheng

XiaoMei

et al. 2022

Cell Mol Biol (Noisy-le-grand)

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This study aimed to explore the effects of ultra-mini percutaneous nephrolithotomy (UMP) combined with ShuoTong ureteroscopy on the stress response, inflammation indicators and urokinase levels in patients with polycystic kidney disease and kidney stones. In this study, 42 patients with polycystic kidney disease and kidney stones diagnosed and treated in our hospital from February 2018 to February 2021 were selected as the research objects. They were randomly divided into the control group and the study group, with 21 cases in each group, and the control group adopted Ultra-mini percutaneous nephrolithotomy treatment; the study group was combined with ShuoTong ureteroscopy on the basis of the control group, and compared and analyzed the stress response, inflammation indexes, urokinase level, renal function, complications and stone clearance rate of the two groups of patients. After treatment, the average operation time, channel establishment time, hemoglobin decline, number of puncture channels, and hospital stay in the study group were significantly shorter than those in the control group (P<0.05); after treatment, the reduction in CRP and PCT in the study group was significantly higher than that in the control group The increase of Ang I and Ang II in the control group was significantly lower than that in the control group (P<0.05); the improvement of PGE2, NO, and LPO levels in the study group was significantly higher than that in the control group after treatment (P<0.05); the study group TH, Cys- The levels of C and β2-MG were significantly lower than those of the control group; the UK levels of the study group were significantly lower than those of the control group (P<0.05); the complication rate of 14.29% in the study group after treatment was significantly lower than that of the control group 33.33%; the study group The stone clearance rate of 95.24% was significantly higher than that of the control group 80.95% (P<0.05). In general, UMP combined with ShuoTong ureteroscopy is used to treat polycystic kidney with kidney stones, accurately determine the tip position of the needle sheath, ensure that the needle sheath enters the collection system to adjust its position, reduce patient stress and inflammation, improve safety and feasibility, and is worthy of clinical practice Promote applications.

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“…We previously reported a preliminary evaluation of the effectiveness of UAP for renal puncture during ECIRS, which indicated the potential benefits of increasing the tubeless rate and shortening the hospital stay. 16 Because this early-stage cohort was too small to reflect realworld data, a larger investigation is necessary to better understand how and why UAP during ECIRS can improve patient care.…”

Section: Introductionmentioning

confidence: 99%

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

et al. 2021

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Objectives: To assess the impact and availability of ureteroscopy-assisted puncture for percutaneous renal access during ultrasonography-guided miniaturized (mini)-endoscopic combined intrarenal surgery for large volume renal and/or proximal ureteral stones. Methods: We conducted a multi-institutional retrospective cohort study for urolithiasis treatment. Data from a total of 313 patients who underwent mini-endoscopic combined intrarenal surgery to treat renal and/or ureteral stones between January 2016 and April 2020 were collected. We compared the outcomes between ultrasonography-guided miniendoscopic combined intrarenal surgery with and without ureteroscopy-assisted puncture (ureteroscopy-assisted puncture(+) group [n = 126] and ureteroscopy-assisted puncture(À) group [n = 187] group, respectively). The primary outcome was requirement for additional surgical intervention. Secondary outcomes were stone-free rate, complications and total procedure, fluoroscopy, hospital stay, and postoperative ureteral stent placement durations. Results: The ureteroscopy-assisted puncture(+) group had a lower additional surgical intervention rate and a higher stone-free rate immediately after and 3 months after surgery than the ureteroscopy-assisted puncture(À) group (5.6% vs 19.7%, P < 0.001; 82.5% vs 65.8%, P = 0.001; 59.5% vs 44.6%, P = 0.011). The median total procedure, fluoroscopy, and postoperative ureteral stent placement durations were 18 min, 3 min, and 5 days shorter, respectively, in the ureteroscopy-assisted puncture(+) group. Multivariate analyses showed that ureteroscopy-assisted puncture was associated with a decreased risk of additional surgical intervention (odds ratio 0.31, P = 0.011) and postoperative infection (odds ratio 0.34, P = 0.003) and decreased total procedure (estimate = À11 min; P = 0.011), fluoroscopy (estimate = À3 min; P = 0.034), and postoperative ureteral stent placement (estimate = À8 days; P = 0.011) durations. Female patients and those with smaller stone volumes or without hydronephrosis were identified as ideal ureteroscopy-assisted puncture candidates. Conclusions: Ureteroscopy-assisted puncture during mini-endoscopic combined intrarenal surgery could provide favorable surgical outcomes, especially in female patients without collecting system obstruction.

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Effectiveness of ureteroscope‐assisted renal puncture for endoscopic combined intrarenal surgery

Cited by 6 publications

References 6 publications

Nonpapillary prone endoscopic combined intrarenal surgery: effectiveness, safety and tips, and tricks

Nonpapillary prone endoscopic combined intrarenal surgery: effectiveness, safety and tips, and tricks

Effect of ultra-mini percutaneous nephrolithotomy and ShuoTong ureteroscopy on the stress response, inflammatory indices, and urokinase level in patients with polycystic kidney disease complicated with renal calculus

Ureteroscopy‐assisted puncture for ultrasonography‐guided renal access significantly improves overall treatment outcomes in endoscopic combined intrarenal surgery

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